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Wide Glucose Swings Equal Poor COVID-19 Outcomes in Hospitalized Patients with Diabetes

A recent study in China suggests that blood glucose variability and blood glucose outside the range of 70-160 mg/dL leads to increased complications in people with diabetes that contract Covid-19. 

This research shows that an A1C, the measure of blood glucose level from the previous three months, does not correctly predict blood glucose variability. A patient could have an A1C within the range of 70-160 mg/dL, but their blood sugars could be frequently higher than 160 or lower than 70. Blood glucose variability is what contributes to a higher risk of adverse outcomes in diabetic patients with Covid-19.

There have been previous studies about high blood glucose being associated with detrimental outcomes in Covid-19 patients with diabetes, but this is the first study that explored both high and low blood sugars outside of the indicated range.

Over the course of about 10 days, 35 patients in a hospital in Wuhan were monitored using isCGM, a continuous glucose monitor. During this time, 15 patients were placed in intensive care, and no patients died.

The patients who experienced adverse effects of Covid-19 were in a blood glucose range between 140-200 mg/dL for a larger percentage of time than the patients who did not experience worse effects. The patients who experienced adverse effects were also under 70 mg/dL for longer time.

Researchers adjusted some factors, and they found that blood glucose variability both above and below the indicated range has a significant impact on a higher risk for adverse effects of Covid-19 on diabetic patients. This extended blood glucose variability was also found to be associated with a longer time of hospitalization.

This increased risk of adverse effects of Covid-19 in diabetics could be due to “neutrophil dysfunction, decreased T-cell immune response, and abnormal humoral immunity.”

Read the original article at medscape.com

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